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Almost 30 years after the introduction of the CIO position, the ideal CIO reporting structure (whether the CIO should report to the CEO or the CFO) is yet to be identified. There is an intuitive assumption among some proponents of IT that the CIO should always report to the CEO to promote the importance of IT and the CIO's clout in the firm, while some adversaries of IT call for a CIO—CFO reporting structure to keep a tab on IT spending. However, we challenge these two ad hoc prescriptions by arguing that neither CIO reporting structure is necessarily optimal, and that the CIO reporting structure should not be used to gauge the strategic role of IT in the firm. First, extending the strategy—structure paradigm, we propose that a firm's strategic positioning (differentiation or cost leadership) should be a primary determinant of its CIO reporting structure. We hypothesize that differentiators are more likely to have their CIO report to the CEO in order to pursue IT initiatives that help the firm's differentiation strategy. We also hypothesize that cost leaders are more likely to have their CIO report to the CFO to lead IT initiatives to facilitate the firm's cost leadership strategy. Second, extending the alignment—fit view, we propose that firms that align their CIO reporting structure with their strategic positioning (specifically, differentiation with a CIO—CEO reporting structure and cost leadership with a CIO—CFO reporting structure) will have superior future performance. Longitudinal data from two periods (1990–1993 and 2006) support the proposed hypotheses, validating the relationship between a firm's strategic positioning and its CIO reporting structure, and also the positive impact of their alignment on firm performance. These results challenge the ad hoc prescriptions about the CIO reporting structure, demonstrating that a CIO—CEO reporting structure is only superior for differentiators and a CIO—CFO reporting structure is superior only for cost leaders. The CIO reporting structure must, therefore, be designed to align with the firm's strategic positioning, independent of whether IT plays a key strategic role in the firm.

Cybersecurity incidents are a growing threat to the health care industry in general and hospitals in particular. The health care industry has lagged behind other industries in protecting its main stakeholder (ie, patients), and now hospitals must invest considerable capital and effort in protecting their systems. However, this is easier said than done because hospitals are extraordinarily technology-saturated, complex organizations with high end point complexity, internal politics, and regulatory pressures. The purpose of this study was to develop a systematic and organizational perspective for studying (1) the dynamics of cybersecurity capability development at hospitals and (2) how these internal organizational dynamics interact to form a system of hospital cybersecurity in the United States. We conducted interviews with hospital chief information officers, chief information security officers, and health care cybersecurity experts; analyzed the interview data; and developed a system dynamics model that unravels the mechanisms by which hospitals build cybersecurity capabilities. We then use simulation analysis to examine how changes to variables within the model affect the likelihood of cyberattacks across both individual hospitals and a system of hospitals. We discuss several key mechanisms that hospitals use to reduce the likelihood of cybercriminal activity. The variable that most influences the risk of cyberattack in a hospital is end point complexity, followed by internal stakeholder alignment. Although resource availability is important in fueling efforts to close cybersecurity capability gaps, low levels of resources could be compensated for by setting a high target level of cybersecurity. To enhance cybersecurity capabilities at hospitals, the main focus of chief information officers and chief information security officers should be on reducing end point complexity and improving internal stakeholder alignment. These strategies can solve cybersecurity problems more effectively than blindly pursuing more resources. On a macro level, the cyber vulnerability of a country's hospital infrastructure is affected by the vulnerabilities of all individual hospitals. In this large system, reducing variation in resource availability makes the whole system less vulnerable-a few hospitals with low resources for cybersecurity threaten the entire infrastructure of health care. In other words, hospitals need to move forward together to make the industry less attractive to cybercriminals. Moreover, although compliance is essential, it does not equal security. Hospitals should set their target level of cybersecurity beyond the requirements of current regulations and policies. As of today, policies mostly address data privacy, not data security. Thus, policy makers need to introduce policies that not only raise the target level of cybersecurity capabilities but also reduce the variability in resource availability across the entire health care system.

The paper empirically examines the effects of social capital of the relationship between the chief information officer (CIO) and top management team (TMT) on organizational value creation based on responses from CIOs and matched TMT respondents from 81 hospitals in the United States. Specifically, we theorize how the three dimensions of social capital-structural, cognitive, and relational social capital-facilitate knowledge exchange and combination between the CIO and TMT resulting in the alignment between the organization's information systems (IS) strategy and business strategy. Results show that IS alignment significantly influences the firm's financial performance and mediates the relationship between CIO-TMT social capital and performance. The findings also indicate that cognitive and relational social capital influence information systems strategic alignment but that structural social capital exerts its influence through its effects on cognitive social capital. Recommendations are provided as to how organizations can develop CIO-TMT structural, cognitive, and relational social capital to positively influence firm performance via IS strategic alignment.

Alignment of information systems (IS) strategy with business strategy is a top concern of both the chief information officer (CIO) and the top management team (TMT) of organizations. Even though researchers and key decision makers in organizations recognize the importance of IS strategic alignment, they often struggle to understand how this alignment is created. In this paper, we develop a nomological network in which shared understanding between the CIO and TMT about the role of IS in the organization (which represents the social dimension of IS strategic alignment) is posited to be a proximal antecedent of the intellectual dimension of IS strategic alignment. We further posit that shared language, shared domain knowledge manifest in the CIO's business knowledge and the TMT's strategic IS knowledge, systems of knowing (structural and social), and CIO-TMT experiential similarity are important determinants of this shared understanding. Data were collected from 243 matched CIO-TMT pairs. Results largely support the proposed nomological network. Specifically, shared understanding between the CIO and TMT is a significant antecedent of IS strategic alignment. Furthermore, shared language, shared domain knowledge, and structural systems of knowing influence the development of shared understanding between the CIO and the TMT. Contrary to expectations and to findings of prior research, social systems of knowing, representing informal social interactions between the CIO and TMT, and experiential similarity did not have a significant effect on shared understanding.

The position of Chief Information Officer (CIO) has become increasingly important in companies. However, it can be perceived that this professional, whose functions are increasingly complex, realizes that his/her core competencies are not always sufficient to tackle the daily professional routine centered around the constant transformations the business arena has witnessed. Thus, by using Social Representation Theory operationalized by the Words Evocation Technique, this article sets out to investigate what the Brazilian IT professional perceptions about the CIO core competencies are, in order to compare them with the Brazilian CIO perceptions about his/her own competencies. The work concludes that in Brazil there is strong cognitive dissonance between those perceptions, as only the “capacity to influence the organization” and “technical expertise” competencies are perceived as being essential competencies for CIOs both by IT professionals and CIOs themselves. Lastly, the article highlights some managerial implications accrued from the results obtained.